Department Analyst I – Credentialing
Cleveland Clinic
full-time
Posted on:
Location Type: Hybrid
Location: Cleveland • Ohio • United States
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Job Level
About the role
- Analyze and evaluate operational and financial functions of administrative and operational units
- Analyze departmental resources, services, systems, budgets and programs
- Prepare and develop special reports and recommendations based on analysis
- Conduct basic statistical analysis and evaluation of unit services and performance
- Identify program or service strengths, weaknesses, and financial impact
- Identify opportunities for service and program improvement
- Assist with the development of operational plans, procedures and systems
- Review and evaluate current procedures and systems and develop recommendations for improvement
- Maintain awareness of and comply with various regulatory guidelines (JCAHO, FDA, HIPAA, OSHA, etc.)
- Manage credentialing for CCF providers across multiple commercial health plans
- Ensure compliance with health plan credentialing criteria and delegated credentialing standards
- Perform primary source verification for licensure and credentials
- Maintain and update large provider rosters in Excel
- Meet tight deadlines (36–48 hours post-committee approval) for releasing providers to health plans
- Coordinate with internal teams to ensure accurate and timely credentialing
Requirements
- Bachelor’s Degree in Business, Healthcare Administration or a related field and one year of statistical analysis experience or five years of relevant experience in a health care setting
- High School Diploma/GED and five years of experience OR Associate's Degree and three years of experience OR Master's Degree
- Two years of commercial health plan credentialing experience OR medical staff office credentialing experience
- Excel proficiency: (filtering, sorting, find/replace, navigating large rosters)
- Understanding of credentialing criteria for health plans
- Knowledge of delegated credentialing vs. manual enrollment
- Knowledge of primary source verification processes
- Comfortable working in a fast-paced environment with large data sets
- Experience with credentialing processes and compliance standards
Benefits
- Outstanding, comprehensive offerings
- Investment in your health, well-being and future
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
statistical analysisExcel proficiencycredentialing processesprimary source verificationprogram evaluationoperational planningbudget analysisdata analysisregulatory complianceservice improvement
Soft Skills
analytical skillscommunicationorganizational skillstime managementattention to detailproblem-solvingteam coordinationadaptabilityinterpersonal skillsdeadline management